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16 May 2006 : Column 946W—continued
(2) whether her Department allows primary care trusts to use the proceeds of disposed assets (a) to fund the rent of additional buildings and (b) for other purposes in connection with delivering healthcare; and if she will make a statement; [69682]
Ms Rosie Winterton: National health service trusts and primary care trusts (PCTs) have delegated limits for capital investment up to which they may make capital investment decisions without seeking approval from their strategic health authority (SHA) or from the Department. These limits vary between £1 million and £10 million, depending on the organisation's turnover from provider activities and performance in the latest star performance ratings.
Purchases of fixed assets and sales of fixed assets such as land and buildings are dealt with in the same way. Beneath its delegated limit, the PCT can sell assets and reinvest the proceeds without the approval of its SHA. Above the delegated limit, the PCT must seekits SHA's approval both for the sale and to reinvest the proceeds. In many instances, SHAs will approve the reinvestment of the sale proceeds by the selling trust or PCT but the SHA retains the discretion to specify another use.
Where the transaction is subject to SHA approval, there will generally be SHA involvement at outline business case, where the main principles and parameters are established and preferred options are chosen, and full business case, where the details of delivering the preferred option are agreed. Even where formal approval by the SHA is not required, NHS trusts and PCTs may wish to draw on their SHA's technical expertise in estate and capital matters.
PCTs are required by statute to operate within resource limits (revenue and capital) set by the Department as part of PCTs funding allocations. PCTs may use their revenue resources for any revenue expenditure permitted in law, including the commissioning of healthcare and community services and payment of rents.
The sale of a fixed asset, such as a building, gives rise to a capital receipt that is a fixed asset financed by capital in the balance sheet is converted to a cash asset financed by capital in the balance sheet. Except to the extent of any profit on disposal, there is no increase in the resources available to the PCT to spend on revenue costs such as rentals.
As a consequence, the sale of a correctly valued fixed asset would not release funds that could be spent on rentals.
For the above reasons, proceeds from the sale of fixed assets are usually reinvested in buying other fixed assets. Where there is no local capital investment requirement, the cash may be repaid to the Department as a repayment of capital.
Respite Care
Kerry McCarthy: To ask the Secretary of State for Health if she will take steps to encourage care homes and nursing homes to include emergency bed provision for respite care users. [71186]
Mr. Ivan Lewis: Councils are responsible for taking the needs and wishes of carers and those they care for into account when planning and commissioning services. If appropriate, councils may arrange for respite care to be provided in a care home, as long as this is in accord with the wishes and needs of service users.
The Government introduced the carers grant in 1999 to support councils in providing breaks and services for carers in England. The grant has increased each year, from £20 million in 1999-2000 to £185 million in 2006-07.
The Carers and Disabled Children's Act 2000 provides local authority social services departments with the option to run short-term break voucher schemes. Short-term break vouchers enable cared for people to make arrangements for the additional support they require when carers need a break.
Sexual Health Services
Mrs. Moon: To ask the Secretary of State for Health what steps her Department is taking to reduce barriers to access to sexual health services with particular reference to young people. [70744]
Caroline Flint: The Government recognise the disproportionate effect of poor sexual health on young people, and this was highlighted in both the national strategy for sexual health and HIV and the teenage pregnancy strategy, and subsequently highlighted in the ‘Choosing Health’ White Paper.
Improving access to sexual health has been identified as a top priority for the national health service in the ‘NHS in England: the Operating Framework for 2006-07’ and all primary care trusts are now working
towards providing access to genito-urinary medicine appointments within 48 hours. A national programme of screening for chlamydia, targeting 16 to 24-year-olds, will be rolled-out across the country by April 2007. A range of projects are also underway to inform the development of new models of service provision. These include HIV testing in community settings and one-stop shop services.
The teenage pregnancy strategy encourages all young people to delay sex, but also seeks to ensure that they have access to contraceptive and sexual health advice if they are, or are thinking about becoming sexually active—to protect themselves against unplanned pregnancy and sexually transmitted infections. Efforts to improve access to services focus on making sexual health services more young people-friendly and delivering them in non-traditional settings, such as schools, colleges and Connexions one-stop-shops.
Spinal Cord Injuries
Mr. Hunt: To ask the Secretary of State for Health (1) what (a) National Institute for Health and Clinical Excellence guidelines, (b) national service frameworks and (c) NHS care protocols exist for the care and treatment of spinal cord injured people; [70824]
(2) what longitudinal data is collected by her Department on the care and treatment of spinal cord injured people within (a) spinal cord injury centres and (b) general and district facilities. [70825]
Mr. Ivan Lewis [holding answer 15 May 2006]: The National Institute for Health and Clinical Excellence has not issued specific guidance on the care and treatment of spinal cord injuries.
The national service framework for long-term conditions is specifically concerned with improving the health and social care needs of those living with long-term neurological conditions, including those with spinal injuries.
The Department does not collect longitudinal data on the care and treatment of spinal cord injuries.
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